Improvement of patients reported outcomes and neurocognitive performances after Direct-Acting Antivirals: a longitudinal study

BACKGROUND: HCV chronic infection may affect Patient-Reported Outcomes (PROs) and HCV related neuroinflammation might correlate with neurocognitive performances (NCP) dysfunction. PATIENTS AND METHODS: A prospective observational study on HCV infected patients treated with direct-acting antivirals...

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Main Authors: S. Odolini, E. Pollastri, S. Volpi, A. Cappa, A. Spinetti, S. Zaltron, P. Nasta, S. Compostella, C. Carriero, G. Zuglian, C. Chirico, S. Calza, F. Castelli, E. Focà
Format: Article
Language:English
Published: Verduci Editore 2021-08-01
Series:Infectious Diseases and Tropical Medicine
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Online Access:https://www.infectiousjournal.com/wp-content/uploads/sites/6/2022/10/e730.pdf
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author S. Odolini
E. Pollastri
S. Volpi
A. Cappa
A. Spinetti
S. Zaltron
P. Nasta
S. Compostella
C. Carriero
G. Zuglian
C. Chirico
S. Calza
F. Castelli
E. Focà
author_facet S. Odolini
E. Pollastri
S. Volpi
A. Cappa
A. Spinetti
S. Zaltron
P. Nasta
S. Compostella
C. Carriero
G. Zuglian
C. Chirico
S. Calza
F. Castelli
E. Focà
author_sort S. Odolini
collection DOAJ
description BACKGROUND: HCV chronic infection may affect Patient-Reported Outcomes (PROs) and HCV related neuroinflammation might correlate with neurocognitive performances (NCP) dysfunction. PATIENTS AND METHODS: A prospective observational study on HCV infected patients treated with direct-acting antivirals (DAA) was conducted at the University Department of Infectious and Tropical Diseases of Brescia, ASST Spedali Civili General Hospital (Italy) from October 2017 to June 2018. Data were collected at baseline (BL), end of treatment (EOT) and 12 weeks after EOT (FU12W). PROs were evaluated with Chronic Liver Disease Questionnaire (CLDQ), Fatigue Severity Scale (FSS), Visual Analogue Fatigue Scale (VAFS) and Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH). Montreal Cognitive Assessment (MoCA) test evaluated NCP. Exclusion criteria were: HIV infection with CD4+ nadir <200 cell/μL or encephalopathy, current alcohol or drug abuse and severe psychiatric disorders. Population features were analysed to identify factors related to PROs and NCP. Statistical significance was considered with p-value<0.05. RESULTS: 76 patients (60.5% males) were analysed: mean age was 60.7, 29 (38.1%) had advanced fibrosis, 6 (7.9%) were HIV/HCV co-infected, 18 (23.6%) took polytherapy (≥5 drugs), ribavirin (RBV) was added in 10 cases (13.1%). Improvements were registered in all questionnaires at FU12W, with significant changes in CLDQ, VAFS and MoCA. Quality of life (QoL) was lower in women and the elderly. RBV assumption temporarily affected QoL and fatigue. Female sex, age and polytherapy were related to worse NCP. HIV/HCV co-infection and fibrosis did not affect scores. CONCLUSIONS: DAA seem to be associated with improvement in PROs and NCP, regardless of fibrosis and HIV/HCV co-infection. These aspects must be considered in real settings, particularly in specific populations including women, the elderly or those assuming polytherapy.
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spelling doaj.art-c08f19a5aa62463283f13d13c04dd56f2023-01-10T10:49:57ZengVerduci EditoreInfectious Diseases and Tropical Medicine2379-40542021-08-01710.32113/idtm_20218_730730Improvement of patients reported outcomes and neurocognitive performances after Direct-Acting Antivirals: a longitudinal studyS. Odolini0E. Pollastri1S. Volpi2A. Cappa3A. Spinetti4S. Zaltron5P. Nasta6S. Compostella7C. Carriero8G. Zuglian9C. Chirico10S. Calza11F. Castelli12E. Focà13University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUnit of Biostatistics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital,, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUniversity Department of Infectious and Tropical Disease, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUnit of Biostatistics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, ItalyBACKGROUND: HCV chronic infection may affect Patient-Reported Outcomes (PROs) and HCV related neuroinflammation might correlate with neurocognitive performances (NCP) dysfunction. PATIENTS AND METHODS: A prospective observational study on HCV infected patients treated with direct-acting antivirals (DAA) was conducted at the University Department of Infectious and Tropical Diseases of Brescia, ASST Spedali Civili General Hospital (Italy) from October 2017 to June 2018. Data were collected at baseline (BL), end of treatment (EOT) and 12 weeks after EOT (FU12W). PROs were evaluated with Chronic Liver Disease Questionnaire (CLDQ), Fatigue Severity Scale (FSS), Visual Analogue Fatigue Scale (VAFS) and Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH). Montreal Cognitive Assessment (MoCA) test evaluated NCP. Exclusion criteria were: HIV infection with CD4+ nadir <200 cell/μL or encephalopathy, current alcohol or drug abuse and severe psychiatric disorders. Population features were analysed to identify factors related to PROs and NCP. Statistical significance was considered with p-value<0.05. RESULTS: 76 patients (60.5% males) were analysed: mean age was 60.7, 29 (38.1%) had advanced fibrosis, 6 (7.9%) were HIV/HCV co-infected, 18 (23.6%) took polytherapy (≥5 drugs), ribavirin (RBV) was added in 10 cases (13.1%). Improvements were registered in all questionnaires at FU12W, with significant changes in CLDQ, VAFS and MoCA. Quality of life (QoL) was lower in women and the elderly. RBV assumption temporarily affected QoL and fatigue. Female sex, age and polytherapy were related to worse NCP. HIV/HCV co-infection and fibrosis did not affect scores. CONCLUSIONS: DAA seem to be associated with improvement in PROs and NCP, regardless of fibrosis and HIV/HCV co-infection. These aspects must be considered in real settings, particularly in specific populations including women, the elderly or those assuming polytherapy.https://www.infectiousjournal.com/wp-content/uploads/sites/6/2022/10/e730.pdfhcvdirect-acting antivirals (daas)patients reported outcomes (pros)neurocognitive performanceshiv/hcv coinfection.
spellingShingle S. Odolini
E. Pollastri
S. Volpi
A. Cappa
A. Spinetti
S. Zaltron
P. Nasta
S. Compostella
C. Carriero
G. Zuglian
C. Chirico
S. Calza
F. Castelli
E. Focà
Improvement of patients reported outcomes and neurocognitive performances after Direct-Acting Antivirals: a longitudinal study
Infectious Diseases and Tropical Medicine
hcv
direct-acting antivirals (daas)
patients reported outcomes (pros)
neurocognitive performances
hiv/hcv coinfection.
title Improvement of patients reported outcomes and neurocognitive performances after Direct-Acting Antivirals: a longitudinal study
title_full Improvement of patients reported outcomes and neurocognitive performances after Direct-Acting Antivirals: a longitudinal study
title_fullStr Improvement of patients reported outcomes and neurocognitive performances after Direct-Acting Antivirals: a longitudinal study
title_full_unstemmed Improvement of patients reported outcomes and neurocognitive performances after Direct-Acting Antivirals: a longitudinal study
title_short Improvement of patients reported outcomes and neurocognitive performances after Direct-Acting Antivirals: a longitudinal study
title_sort improvement of patients reported outcomes and neurocognitive performances after direct acting antivirals a longitudinal study
topic hcv
direct-acting antivirals (daas)
patients reported outcomes (pros)
neurocognitive performances
hiv/hcv coinfection.
url https://www.infectiousjournal.com/wp-content/uploads/sites/6/2022/10/e730.pdf
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